Consider This Before Taking St. John’s Wort

Due in large part to increasing health care costs and the unknown long-term effects of many popular medications, complementary and alternative medicine are growing in popularity. But there are some important factors to keep in mind when seeking natural remedies for common ailments.

Take depression, for example. For those attempting to manage depression without the assistance of prescription medications, St. John’s wort is often suggested as an over-the-counter alternative to an SSRI. But new data from Wake Forest University indicates that many patients may be unaware of the dangerous interactions that can occur between supplements made from the flowering plant and commonly-prescribed medications for other ailments.

“Patients may have a false sense of safety with so-called ‘natural’ treatments like St. John’s wort,” says lead study author Sarah Taylor, M.D., assistant professor of dermatology at Wake Forest Baptist Medical Center in a statement. “It is crucial for physicians to know the dangers of ‘natural’ treatments and to communicate the risks to patients effectively.”

After analyzing the records of more than 2.2 million doctor’s visits between 1993 and 2010, Taylor and her colleagues discovered that 28 percent of encounters between physicians and patients involved the discussion of taking St. John’s wort in conjunction with other drugs that could cause a harmful reaction.

Dangerous drug interactions

For centuries, St. John’s wort has been used to treat everything from burns to mental disorders. The supplement can be found over-the-counter in the form of capsules, tablets, teas and extracts.

Prescriptions that can interact dangerously with St. John’s wort include the following, among others:

statins

warfarin

levodopa

benzodiazepines

oral contraceptives

SSRIs

calcium channel blockers

beta-blockers

antiarrhythmics

immunosuppressants

The combination of St. John’s wort and these prescriptions can lead to potentially lethal amounts of serotonin to buildup in the body (when combined with antidepressant medications), and may contribute to heart disease and unplanned pregnancy due to the unanticipated failure of blood pressure and contraceptive medications.

Preventing these disastrous outcomes is a multi-step endeavor, according to Taylor. She calls for more obvious labeling of risks and warnings on packages of St. John’s wort, as well as increased awareness among doctors who need to start talking to their patients about the vitamins and supplements they’re taking and how those over-the-counter ingredients can affect prescription medications.

Does St. John‘s wort really work?

The Food and Drug Administration has not given St. John’s wort the green light to be used as a treatment for depression, and a collection of conflicting research results indicates that the jury is still out on whether the supplement can have a measurably positive effect on those seeking relief from the condition.

The National Center of Complementary and Alternative Medicine cautions those considering taking St. John’s wort to have a candid discussion with their doctor before taking any additional supplements.